+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The implementation of a standardized approach to laparoscopic rectal surgery



The implementation of a standardized approach to laparoscopic rectal surgery



Jsls 16(2): 264-270



The purpose of this study was to audit our results after implementation of a standardized operative approach to laparoscopic surgery for rectal cancer within a fast-track recovery program. From January 2009 to February 2011, 100 consecutive patients underwent laparoscopic surgery on an intention-to-treat basis for rectal cancer. The results were retrospectively reviewed from a prospectively collected database. Operative steps and instrumentation for the procedure were standardized. A standard perioperative care plan was used. The following procedures were performed: low anterior resection (n = 26), low anterior resection with loop-ileostomy (n = 39), Hartmann's operation (n = 14), and abdominoperineal resection (n = 21). The median length of hospital stay was 7 days; 9 patients were readmitted There were 9 cases of conversion to open surgery. The overall complication rate was 35%, including 6 cases (90/%) of anastomotic leakages requiring reoperation. The 30-day mortality was 5%. The median number of harvested lymph nodes was 15 (range, 2 to 48). There were 6 cases of positive circumferential resection margins. The median follow-up was 9 (range, 1 to 27) months. One patient with disseminated cancer developed port-site metastasis. The results confirm the safety of a standardized approach, and the oncological outcomes are comparable to those of similar studies.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 056372497

Download citation: RISBibTeXText

PMID: 23477176


Related references

Implementation of laparoscopic rectal cancer surgery. Cirugia Espanola 79(3): 154-159, 2006

Open Surgery Against Laparoscopic Surgery for Mid-Rectal or Low-Rectal Cancer of Male Patients: Better Postoperative Genital Function of Laparoscopic Surgery. Surgical Laparoscopy Endoscopy and Percutaneous Techniques 25(5): 444-448, 2015

Laparoscopic colorectal surgery in learning curve: Role of implementation of a standardized technique and recovery protocol. A cohort study. Annals of Medicine and Surgery 4(2): 89-94, 2015

Intersphincteric resection for very low rectal cancer: clinical outcomes of open versus laparoscopic approach and multidimensional analysis of the learning curve for laparoscopic surgery. Journal of Surgical Research 183(2): 524-530, 2013

Three-step standardized approach for complete mobilization of the splenic flexure during robotic rectal cancer surgery. Colorectal Disease 18(5): O171-O174, 2016

Short-term outcomes of laparoscopic intersphincteric resection from a phase II trial to evaluate laparoscopic surgery for stage 0/I rectal cancer: Japan Society of Laparoscopic Colorectal Surgery Lap RC. Surgical Endoscopy 26(11): 3067-3076, 2013

Laparoscopic rectal surgery: rectal cancer, pelvic pouch surgery, and rectal prolapse. Surgical Clinics of North America 86(4): 899-914, 2006

Intersphincteric resection for low rectal cancer: laparoscopic vs open surgery approach. Colorectal Disease 14(1): 35-41; Discussion 42-3, 2012

Implementation of fast-track protocols in open and laparoscopic sphincter-preserving rectal cancer surgery: a multicenter, comparative, prospective, non-randomized study. Digestive Surgery 29(4): 301-309, 2012

Colo-rectal surgery, through laparoscopic approach. Considerations concerning a personal experience of 613 cases. Chirurgia 98(5): 417-424, 2003

An integrated multidisciplinary approach to implementation of a fast-track program for laparoscopic colorectal surgery. Canadian Journal of Anaesthesia 56(11): 837-842, 2009

Hand-assisted laparoscopic surgery versus the open approach in curative resection of rectal cancer. Journal of International Medical Research 38(3): 916-922, 2010

A comparison of hand-assisted laparoscopic surgery and conventional laparoscopic surgery in rectal cancer: a propensity score analysis. Surgical Endoscopy 30(6): 2449-2456, 2016

A Comparative Study of Single-Port Laparoscopic Surgery Versus Robotic-Assisted Laparoscopic Surgery for Rectal Cancer. Surgical Innovation 22(4): 368-375, 2015

Considering Value in Rectal Cancer Surgery: An Analysis of Costs and Outcomes Based on the Open, Laparoscopic, and Robotic Approach for Proctectomy. Annals of Surgery 265(5): 960-968, 2017